PHA-Exch> DRUG-RESISTANT TUBERCULOSIS ON THE RISE, UN HEALTH AGENCY SAYS

[Claudio Schuftan]

From: Vern Weitzel <vern at coombs.anu.edu.au>
crossposted from: "[health-vn discussion group]" health-vn at cairo.anu.edu.au


DRUG-RESISTANT TUBERCULOSIS ON THE RISE, UN HEALTH AGENCY SAYS

Rates of multi-drug-resistant tuberculosis – which takes longer to treat and
requires more expensive drugs that have potentially serious side effects –
are
at an all-time high, according to a new
<"http://www.who.int/mediacentre/news/releases/2008/pr05/en/index.html
">report
by the United Nations World Health Organization (<"http://www.who.int/en/
">WHO).

The study, entitled "<i>Anti-Tuberculosis Drug Resistance in the World</i>,"
is
the largest ever on the scale of drub resistance and is based on information
collected between 2002 and 2006 on 90,000 TB patients in 81 countries.

The agency estimates that there are nearly half a million new cases of
multi-drug-resistant TB, known as MDR-TB, annually worldwide, accounting for
5
per cent of the 9 million new cases every year.

"TB drug assistance needs a frontal assault," said Mario Raviglione,
Director
of WHO's Stop TB Department. "If countries and the international community
fail
to address it aggressively now we will lose this battle."

The highest rate of MDR-TB was found in Azerbaijan's capital Baku, where
nearly
one quarter of all new TB cases were reported to be multi-drug-resistant.
WHO
said that this type of TB is also widespread in Moldova; Donetsk, Ukraine;
Tomsk
Oblast, Russia; Tashkent, Uzbekistan; and China.

The report also spotted ties between HIV infection and MDR-TB, with surveys
in
Latvia and Donetsk, Ukraine, noting that the rate of MDR-TB is twice as high
among tuberculosis patients living with HIV than it is among those without
HIV.

For the first time, the worldwide survey included analysis of extensively
drug-resistant tuberculosis, or XDR-TB, which is virtually untreatable. It
has
been recorded in 45 countries, but because few countries are currently
equipped
to diagnose it, limited data were available for inclusion in the current WHO
study.

The agency reported notable successes, such as Estonia and Latvia, which
were
deemed MDR-TB 'hotspots' more than a dozen years ago but whose rates are now
stabilizing.

However, given that only six countries in Africa – the continent with the
highest incidence of TB globally – were able to submit data for the report,
WHO
pointed out that the magnitude of the respiratory disease in some parts of
the
world remains unknown.

"It is likely there are outbreaks of drug resistance going unnoticed and
undetected," said WHO tuberculosis expert Abigail Wright, the report's
principal
author.
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